David Cairns: My hon. Friend is right to point out the economic contribution that individuals from theA8 countries are making in Scotland. They are entitled to the same employment protection as everyone else, including rights to the minimum wage. It is important that those workers receive the minimum wage and are not used to undercut wage rates throughout Scotland. He mentioned the issue of gangs, and he is sitting beside our hon. Friend the Member for Paisley and Renfrewshire, North (Jim Sheridan) who, through his gangmaster legislation, has done more than anyone else to highlight the issue, for which I pay tribute to him. It is absolutely right that people coming into this country are treated fairly and on a level playing field with everyone else.

Douglas Alexander: Since 1999 the Government have committed £29 million to the research and development of marine energy technologies. In addition, we have created the marine renewable deployment fund with a further£50 million allocated to help projects move from the research stage to demonstration. Moreover, we have invested in infrastructure. That investment includes £15 million for the European Marine Energy Centre in Orkney, a dedicated test facility for wave and tidal technology developers.

Phil Woolas: I thank my hon. Friend for that important question, which gives me the opportunity to confirm that that is the case. The Government's policy is to have a presumption against ring-fencing in funding. May I tell the House through you, Mr. Speaker, that this year the local area agreements will receive £520 million of pooled money and that that will rise to up to£1.5 billion in the financial year 2007-08, so I can confirm that the answer to the question is yes.

Phil Woolas: I was as confused by that question as I was by the hon. Lady's contribution to last night's debate. I repeat what I said: it makes perfect sense—to me it is common sense, and I think that the Opposition are trying to find ways to oppose for the sake of opposing—to have the White Paper and the Bill on local government functions before looking at financial proposals and any legislation that might be produced, because if that is required it will have to be introduced in the next parliamentary Session.

Phil Woolas: I cannot give that guarantee. With respect, I think that the hon. Lady is rather confused about what her own policy is. The Opposition have asked for a permissive regime that would allow local authorities to put forward proposals for restructuring, where they wish to do so. The deadline for initial proposals is the end of the current week, and I suspect that there will be proposals from local authorities of all types and all political colours from across the country. Some of them will be Conservative and some will not be, and I await all the proposals with interest.

Phil Woolas: I strongly advise the hon. Gentleman who speaks for the Liberal Democrats seriously to revise his policy on business rates. At present,£17.5 billion is redistributed through the non-domestic rating system, as opposed to £3.335 billion through the remainder of the revenue support grant—RSG. Of that £17.5 billion, some four or five councils contribute almost 10 per cent. The redistributive effect of the national non-domestic rates—NNDR—in the absence of the dedicated schools budget from the RSG renders his policy one that would significantly damage the poorer areas of this country. Therefore I cannot give him the guarantee that he asks for.

Andrew Gwynne: When considering the Lyons review findings, can my hon. Friend look at better developing ways to ensurethat those—sometimes not insubstantial—areas of the country that have pockets of deprivation and real need but which are located in local authorities that are considered to be affluent do not miss out on the additional funding that they need and deserve?

Phil Woolas: I commend my hon. Friend for raising again a problem that one of the local authorities in his constituency faces. Members of different parties point to wards or sub-ward areas that have povertyand deprivation that are not recognised in eitherthe neighbourhood renewal fund or, it is argued, the RSG—although it is, of course, weighted within the RSG. I cannot give my hon. Friend the commitment that such changes will be made in the current financial period, but I do give the commitment that I will look at it for the future spending review period.

Ruth Kelly: May I say how wholeheartedly I welcome the hon. Gentleman's commitment to look at all sources of funding and, indeed, land for new affordable housing. Indeed, we will look at any option that heor anyone else puts forward to increase the supply of land for that purpose. I read recently of the hon. Gentleman's claim that his new-found interest in community land trusts was inspired by the Levellers of the English civil war. I am rather more interested in the current civil war in the Conservative party on whether to build new homes for affordable housing. Indeed, only last month the hon. Gentleman said, "I think"—

Paul Rowen: What progress has been made towards achieving the Decent Homes standard.

Yvette Cooper: The hon. Gentleman raises an important point. I know that the arm's length management organisation in Rochdale has almost completed its programme and, thanks to the £100 million provided by the Labour Government, will have refurbished and modernised more than 16,000 homes in the area, ensuring that they meet the proper standards for central heating and insulation. The hon. Gentleman is right to say that we need to support private sector homes to ensure that pensioners in particular are not living in cold homes. The warm front programme has already assisted1.2 million households across the country and we want to go further in helping to warm and insulate more such households.

Stewart Jackson: One consequence of the Government's mismanagement of EU migration is the great strain placed on social and private sector housing in some parts of the country. What are the Government going to do aboutthe exploitation of EU migrants by unscrupulous landlords? Also, the poor condition of many houses in multiple occupation is a major problem in places such as Peterborough, where we have 6,500 people on the council waiting list. What are the Government going to do about that?

Ruth Kelly: My Department has made considerable progress over the past year, delivering on a range of commitments set out in the Respect action plan. For example, my right hon. Friend the Prime Minister and I earlier this month announced new regulations that will give arm's-length management organisations and tenant management organisations powers to apply for anti-social behaviour orders.

Hugo Swire: I beg to ask leave to move the Adjournment of the House, under Standing Order No. 24, to discuss a specific and important matter, which I believe should have urgent consideration, namely,
	"the situation surrounding the wreck MSC Napoli now lying off the coast in Lyme bay in my constituency of East Devon".
	I would like to take this opportunity to thank the Minister of State, Department for Transport, the hon. Member for South Thanet (Dr. Ladyman) for his courtesy in keeping me informed at all stages. I should also like to record my thanks to the Secretary of State's representative, Robin Middleton, and his staff at the Maritime and Coastguard Agency, to Devon and Cornwall constabulary, to the Environment Agency and others in the emergency services who are working tirelessly to mitigate what could have been a far worse situation.
	The sensitivity of all this is exacerbated by the fact that the Jurassic and Triassic coastline in east Devon and west Dorset is a UNESCO world heritage site. The coastline also includes a number of sites of special scientific interest.
	The media images from the beach in Branscombe show that some members of the public are behaving in a dangerous free-for-all and quite unacceptable manner. The police have felt disempowered at times, not least in their inability to close off the beach straight away. Ministers need to revisit the legislation when events of this nature occur. Although 103 containers have been lost from the ship, to date only 53 have been located on shore. Fifty tonnes of dirty fuel have been washed ashore. Although clean-up operations have commenced and work has begun to discharge the bunker fuel into a reception vessel, that could take a week, during which time the ship, which is between 17° and 25° down at the stern, depending on the tide—is at the mercy of the weather. I am travelling to Brussels tomorrow to meet Jacques Barrot, the Transport Commissioner, to see what lessons can be learned from this incident and to find out what help can be provided to clean up the environmental damage.
	My constituency is largely dependent on tourism and we will need assistance to deal with the fall-out of this incident—in the short and long term—particularly when the wreck is likely to remain where she is for at least a year. My constituents need to be reassured that none of the costs of cleaning this up will have to be met by the council tax payers of East Devon. They also seek reassurance that no more damage will be doneto the environment from any protracted clean-up operation and that every step possible is being taken to protect the wildlife affected by the spillage.
	Many questions surrounding the beaching of MSC Napoli need to be answered and I believe that the House should have the opportunity, at the earliest time available, to question Ministers about the events surrounding that unfortunate incident.

John Pugh: I beg to move,
	That leave be given to bring in a Bill to require the provision to Parliament of certain information relating to intergovernmental contracts; and for connected purposes.
	The Bill is designed to deal with an absurdity and a scandal, and its genesis is easy to explain. A short while ago, as a member of the Public Accounts Committee, I was prompted to ask why the National Audit Office report on the al-Yamamah arms deal had not been published—a simple enough inquiry, not especially original and not without wider interest. The Committee convened in special session to answer the question. It met in camera, and I am not, frankly, allowed to tell the House what was said or who was there, although I will say that some eminent people were there—people who do not usually attend that Committee.
	I can also say what the outcome, the conclusion, was: we discovered that no one on the Committee—none of the customarily fierce interrogators on the committee, nor the Chairman, nor a single living Member—has a right to see the document, even though it is about a Government contract, even though we can see every other NAO report ever written and even though it was written by a man who is technically a servant of the House.
	The only Member who was ever gifted the privilege of reading was the former Member for Ashton-under-Lyne, Lord Sheldon. Once the reading had been delegated to him, it seemed that no living soul could clap eyes on it again. My Bill seeks to rectify that absurdity. It would not ensure the publication of the NAO report. It would not undo the past. It seeks simply to provide a mechanism whereby Parliament's right at least to scrutinise the doings of Government can be preserved.
	The Bill would apply only to commercial contracts in which the Government are involved. There is force in the argument that, if some of those contracts were exposed to prolonged public debate, the kind of economic benefits that they were designed to secure would be defeated, thus putting at risk jobs, embarrassing international partners or jeopardising other national, perhaps security, interests. I accept that those who point that out make a serious moral claim, but I cannot accept that the House must forfeit the right to examine such a claim and establish whether it has substance or is simply a claim made to cover up a less ethical position.
	When the Serious Fraud Office inquiry was dropped before Christmas in a cunning Government plan that even Baldrick might have bettered, I suggested in the Chamber to Solicitor-General that the understandable suspicion provoked, and now snowballing, could be allayed by allowing wider access to the report, perhaps on a confidential basis. He pointed out correctly that that was a matter for the House, but he and I both knew that that meant that it was matter for the business managers—the Whips—who can block indirectly or directly any attempt to change the status quo, and believe you me, they will.
	The Bill is an attempt to establish procedure whereby, if sufficient Members make application to the Leader of the House—he is here now—for the scrutiny of documents such as the al-Yamamah report, he must refer those documents to a relevant Committee of the House for scrutiny, perhaps with appropriate caveats. Parliament's right to scrutiny would thus be minimally preserved. I would add that the Committee must refer the issue back to the House if, and only if, apparent evidence of a breach of national or international law was found.
	I strongly believe that such a minimal mechanism needs to exist, if only to show that Parliament is not reduced to the supine, ludicrous position where it is not even allowed to read its own papers, simply because the Government, with a host of obviously shoddy arguments, tell us that it can do us no good.
	We all know that there are pros and cons. Jobs may be lost if we go one way; international and public respect will definitely be lost if we go another. The battle for orders and influence is on one side, and the battle for commercial ethics is on the other. And we can come down on either side irrespective of whether we are moral pragmatists or moral purists. Whatever side we are on, however, we all have to recognise that the Government's current position is simply unsustainable and, like all unsustainable positions, it will only get worse. Thanks to their cack-handed approach, no one now believes that the serious fraud squad was getting nowhere. Everyone now believes that BAE gave out bribes and the Saudis took them. Accusation and allegation, and naming and shaming fill the pages of  The Guardian. The media have, de facto, painted a worse picture than the dear old National Audit Office ever could, or does. Imagination flourishes in the face of the shiftiness that sits on reports, stops investigations and mistakenly tries to rope the intelligence services into the whole charade. The Saudis are not now being criticised; they are being demonised. Our European allies are outraged and the corrupt regimes of the world are smugly vindicated by our apparent and cynical display of grubby realpolitik.
	Parliament perhaps ought to try to rescue the Government from themselves. The Government are aiming for closure, but are opening can after can of worms. The clear plea in the recent official Saudi press release to be able to move on and acknowledge some of the changes made in the kingdom goes completely unheard. That press release, which is on the website, says explicitly:
	"the government of Saudi Arabia today will not and does not condone fraudulent or corrupt behaviour of any kind and would take firm action against anyone found to be involved in fraudulent activity or found accepting or offering bribes of any kind. This is against the law. This should clarify any misperceptions about the Kingdom. We cannot rewrite the past, but we must look...towards the future."
	Without even the most minimal checks and balances on international contracts, the present is clouded by a miasma of suspicion and allegation from which neither BAE, nor Saudi Arabia, nor the Government can get clear. That damages them and wider human and commercial interests. All reputations—including those of Parliament and the Public Accounts Committee—are in the collective mire. To do nothing to avoid further repetition of past mistakes is itself culpable.
	I am reminded of the Government's approach to the British citizens wrongly accused of bomb outrages in Saudi Arabia. I was involved, to an extent, in that matter. What did the Government's hesitant and limp-wristed approach on behalf of innocent Britons lead to? It led to two years of appalling publicity for Saudi Arabia, two years of suffering for the innocent and time bought for the al-Qaeda cell that made and planted the bombs. Let us have no lectures about security from the Government. If we wish BAE to have a business reputation as unsurpassed as its technical excellence, if we wish for an equal and understanding friendship with the kingdom of Saudi Arabia and its people, and if we wish for protection against the next scandal or allegation that is going to ripen, whether from Tanzania or elsewhere, self-evidently we cannot leave matters to the Government. Parliament must assert its right to scrutiny or abjectly acknowledge its impotence. I beg all Members to support the Bill.
	 Question put and agreed to.
	Bill ordered to be brought in by Dr. John Pugh, Nick Harvey, Mr. Michael Moore, Susan Kramer, Dr. Vincent Cable, Lynne Featherstone, Norman Lamb, Simon Hughes and Mr. Paul Burstow.

Andrew Lansley: I beg to move,
	That this House, while recognising the commitment and efforts of NHS staff to minimise infection rates, is alarmed at the continuing high levels of healthcare-acquired infections; notes that the NHS is not on track to meet the target for reducing MRSA bloodstream infections in 2008 and that new highly virulent MRSA strains are emerging; is shocked at increasing rates of Clostridium difficile infection which the Department of Health now regards as endemic in the health service; calls on the Government and the NHS to accelerate actions to combat levels of healthcare-acquired infections, including reduced bed occupancy rates, increased isolation facilities and single rooms, improved hand hygiene, enhanced hospital cleaning incorporating novel processes, and the rigorous screening of patients; commends the adoption of a uniform policy within NHS trusts; calls for the piloting by the NHS of a 'search and destroy' strategy against the most virulent strains of MRSA and Clostridium difficile; and demands that the Government report six-monthly to the House on the action it is taking to combat healthcare-acquired infections.
	I want to start, as our motion does, with a recognition of the work that the NHS does to seek to minimise infection. I am sure that many hon. Members visit hospitals, particularly their local hospital, and have occasion to discuss infection control measures, and I am sure that they appreciate the effort being made. I recall visiting a hospital a year or so ago and speaking to a sister in charge of a ward. I appreciated what she had achieved, as there had been orthopaedic patients on that ward for a substantial period, without any infections occurring. One then realises just how much the matter comes down to individual members of staff. I talked to the chief executive as we left that ward, and asked to visit the adjoining stroke ward. He said, "Unfortunately, we can't do that, because it's closed at the moment due to an infection." That made me realise that control of the measures taken on wards makes a big difference.
	We introduced the motion today simply because we have raised infection control issues many times over the past three years, and we want action and need progress. The House needs an opportunity to learn why that action has not been taken, and why that progress has not been made. Our motion this afternoon is intended to provide precisely that opportunity. Let us consider where we are on the issue, and what has been done.In 2005-06, some 7,097 MRSA—methicillin-resistant Staphylococcus aureus— bloodstream infections were reported. That was a reduction of 8 per cent. in relation to the 2003-04 baseline for the Government's target of halving the number of MRSA bloodstream infections by 2008. However, that should be put in context, because the number of deaths associated with MRSA has tripled since 1997. As we said back in 2004, halving MRSA rates would in fact do no more than bring them back to the levels that pertained at the end of the 1990s. Of course, the bloodstream infections that are the subject of the Government's target do not include surgical site infections.
	Since the Government's target was introduced, and even in recent months, more serious and more toxic forms of MRSA have appeared, including PVL—I will not attempt to give its scientific name—a dangerous form of MRSA in which a toxin that attacks leukocytes is emitted. It can lead to conditions such as necrotising fasciitis, which can lead to death in a matter of hours—within 72 hours. Serious and highly toxic forms of MRSA are appearing in hospitals, but the particular form that I mentioned is generally associated with community-acquired MRSA.

David Heath: I agree that there has been a huge effort by staff and the Government to improve infection control. Without wishing to sound too much like an old soldier, 25 years ago, I worked in an operating theatre, and I am surprised by the laxity of procedures now. Some staff, for instance, wear jewellery while in uniform, follow aseptic procedures, or wear scrubs outside theatre. A St. Thomas's-trained sister would have scalped people for such surprising practices a few years ago, but the procedures that she enforced do not appear to be part of basic training today.

Anne Main: Unfortunately, my health authority and trusts have the same problem.Dr. Martin Woolaway, the director of public health for my authority, stated in a report to the NAO about preventing infections:
	"Preventing infections continues to be adversely affected by high bed occupancy, the movement of patients and the lack of beds to allow separation of elective and trauma patients."
	Neither of my hospital trusts have isolation wards. That is sadly endemic.

Andrew Lansley: That is disgraceful. Last year, 40 per cent. of nurses reported that they did not have sufficient time to clean beds thoroughly between patients. That is central to proper infection control.
	What about undertaking wider surveillance and inspection instead of the Government's narrow targets? The Minister asked what he should have done in response to the memorandum from the director of health protection. He should have said that the Government would redouble their efforts, not only in relation to MRSA bloodstream infections but a wider range of infections. He should have agreed to disseminate that data and ensured that people could act on the information.
	What about cleaning? The Minister is apparently interested in that and believes that the problem will be solved by in-house cleaning. Why, two years after the publication in 2004 of the model cleaning contract, which was trumpeted as a way of ensuring high standards of cleaning, could Norman Rose of the Business Services Association say that
	"in about all the contract renewals over the past two years, Trusts have requested that contractors do not quote on the basis of the 2004 Cleaning Standards as they cannot afford it"?
	What is the point of in-house or out-sourced cleaning if the management does not try to fulfil the cleaning contract and the model cleaning standards?
	What about the rapid review panel? I am not sure which Minister is now responsible for that. It might be one of the Ministers in the Chamber today, or their colleague in the other place. The rapid review panel was supposed to expedite the introduction of new processes and technologies into the NHS that would be useful in combating infections. Of the 168 products that were assessed, three received a recommendation 1, which meant that they were already in use. Everything else got a recommendation 2 or 3.
	Every company that I have spoken to has the same story about this process. They put together their dossier and provided a great deal of information. That took months, and they received no feedback. They were told that they would be given a recommendation. They were told, "Your product might well be useful. Off you go and prove it yourself. Run a clinical trial. Sell it to the NHS." Those were things that they could and would have done themselves, but for the fact that they thought that the rapid review panel was there to help them to introduce those processes. Instead, it is a paper exercise with a committee that publishes obiter dicta from its throne, and nobody in the NHS is required to do anything about this at all. No one in the Department of Health uses health technology development budgets, for example, to take forward those technologies and prove that they work. Nothing gets done as a result of the so-called rapid review panel.
	Those technologies are out there, however. Last Wednesday, I was at the recently established centrefor health care-acquired infections at Nottingham university. In one of the presentations at its launch, it reported on portable clean air technology systems that have demonstrable benefits in reducing MRSA infections, and on a hydrogen peroxide vapour system that has very promising benefits for eliminating Clostridium difficile. But where is the support for that?
	The National Audit Office report stated that more than half of the trusts had undertaken a risk assessment to determine what level of isolation facilities they required, yet only a quarter of those had put the measures in place, and that that had usually happened only in conjunction with new build or major capital projects. That is not good enough, and these things are not happening fast enough.
	Last June, the Scottish health technology assessment reported that three isolation beds per 25-bed ward should be provided to back up a policy of screening all admissions. Will the Secretary of State commit today to providing the necessary capital resources to put in three isolation beds per 25-bed ward in order to support a policy of screening all admissions? The point was raised earlier about tackling community- acquired infection— [ Interruption.] No, you are the Government. I am sorry, Mr. Deputy Speaker. They are the Government, yet they sit on the Front Bench and ask me what I would do. Crikey!
	I was talking about screening. Before the last election, my right hon. and learned Friend the Member for Folkestone and Hythe and I said that, as a Government, we would spend the money necessary to introduce the screening of all admissions. The Government have done nothing about that until the document of November 2006 that they have just published. It states:
	"The logical conclusion of risk factor assessments and the results of modelling studies"—
	the Department of Health always provides us with a good read—
	"is that the most appropriate approach to the reduction of MRSA carriage in the population, and resultant MRSA infections, is the universal screening of all admissions to hospitals."
	Instead of just handing out that document and letting trusts review their policies, will the Government put in place the isolation facilities that would enable the screening of all admissions to hospitals? They say that that should happen, but it is not happening.
	I saw the equipment at the centre for health care-acquired infections at Nottingham university, and it was extremely interesting. Professor Richard James is taking the DNA testing of bacteria to the next stage, which will enable us rapidly to identify the different strains of infection, and of MRSA in particular. Being able to identify the genetic fingerprint of the different strains will enable us to determine the extent to which the MRSA infection in a hospital is the result of a community-acquired MRSA or a hospital-acquired MRSA. This will help us to understand the prevalence of those infections in hospitals.

Andrew Lansley: That was a completely pointless intervention. We went into the last election with a commitment to a comprehensive programme of tackling infections, not just with a target. We included a commitment to a mandatory surveillance system that was wider than both the one that the Government had at a time and the one that they have implemented now. When we are in government, it will be our responsibility to ensure a comprehensive system of infection control.
	That brings me to two final points. The hon. Member for Somerton and Frome (Mr. Heath) asked about uniforms. It is important to know what the Government are planning in that regard. The Leader of the Opposition has made it clear that we want the code of practice, which the Government put laboriously into legislation last year, to reflect the need for changing, showering and laundering facilities in hospitals. I accept that that will not be cheap, but it is not provided for in the code of practice, and the Government appear unable to commit to it. At the moment, the Royal College of Nursing tells us that half of nurses are not able to change at work, six out of 10 are not able to shower at work—we are all able to shower in Portcullis house, and nurses certainly need that facility at work—and six or seven out of 10 are not able to have uniforms laundered at work.
	The issue relates to nurses' working conditions, the standards that they want to maintain, a comprehensive approach to hygiene in hospitals and the confidence that the public have in the system on which they depend. The Minister said that Chris Beasley, the chief nursing officer, intended to set up an expert group to consider uniforms policy, which was to report in spring 2006. The latest reply in December 2006 said that it will report in spring 2007. Once again, the Government are all talk; there is no action.
	Finally, in relation to "search and destroy", the chief medical officer published "Winning Ways" in December 2003, which set out clearly the success—that is what he called it—that the Danes and the Dutch had achieved with a search and destroy strategy against MRSA. In September 2004, I challenged the Government to say whether they would have a search and destroy strategy. Their answer was that they were getting experts from abroad to come to the country and tell us what we should be doing. I challenged them again to say what they were doing. Lo and behold, more than three years later, Michael White wrote in last week's  Health Service Journal that the chief medical officer had sent a team to the Netherlands to find out about search and destroy strategies.
	We knew in December 2003 that a search and destroy strategy was a possibility. I know why Ministers did not implement it: it is costly, and it would take six years, according to modelling by Nottingham university, for such a strategy to deliver a result whereby MRSA and other infections were no longer endemic in the NHS. The then Secretary of State, the right hon. Member for Airdrie and Shotts, said, "I want a target now, and I want it all to be running in the middle of the next Parliament." He made it up, and it is not good enough. It is not good enough that the Government are not taking action, and it is not good enough that their amendment makes no reference to the commitment and work of NHS staff in combating infections, makes no reference at all to C. difficile, and contains no commitment to further action to deal with infections.
	The purpose of the debate and our motion is straightforward: we are calling for there to be no more excuses, no more complacency, no more targets that distort the task of dealing with infections, and no more rhetoric without results. The Government must commit themselves to action. Our motion sets out the kinds of actions required, which would support and enable the NHS to deliver the highest standards of infection control anywhere in the world, which we need and should aspire to have. Our motion, not least because Ministers have not volunteered any time since the election to discuss infection control, would require Ministers to come to the House every six months to tell us what they have been doing. I commend the motion to the House.

Patricia Hewitt: I will make a little more progress before I give way again.
	As I say, we were the first Government in the world to introduce mandatory reporting. We followed that up with our target, since when MRSA rates have been falling—not simply because we set a target, but because we focused on the issue with the NHS and we supported it in taking the right action.
	It is worth remembering the scale of the problem that was emerging. MRSA rates began to increase in the early 1990s. Figures from the Health Protection Agency reporting system show that in the last four years of the disastrous Conservative health policy from 1993 to 1996 MRSA rates were doubling, or nearly doubling, every year—an exponential growth in MRSA rates. I have no doubt that if we had not introduced mandatory reporting, made that a top priority for the NHS and set a target, those MRSA rates would continued to rise. Instead, we first slowed the increase, then we got it down to single figures, and now the NHS is cutting the number of cases. Not only has there been an 8 per cent. reduction in MRSA rates in the past two years, but over the past two years in the NHS in the winter period, when hospitals are at their busiest, there has been an 11 per cent. reduction in MRSA rates.

Patricia Hewitt: The hon. Gentleman raises an important point. Many hospitals have introduced protected hours for visiting and controls on numbers, and several NHS foundation trusts engage their members in decisions on such restrictions. However, I must say that, once again, the hon. Gentleman is asking the Government to decide. Does he want us to set a target for the number of visitors that there should be at any one time, or where they should sit?
	Let me say a little more about targets. We set the target of halving the MRSA rate, and I am sure that if we had not set that target the rate would have been going up rather than down and that we would have a much bigger problem than we already have. However, we always said that the target would be challenging—my right hon. Friend the Member for Airdrie and Shotts (John Reid) said that at the time. There is no point in setting easy targets. We need to set challenging targets in order to ensure that everybody makes the greatest possible effort to deal with a problem that affects the NHS as a whole.
	The Opposition are against targets. They have been busy telling the press that they will get rid of allthe NHS targets. The hon. Member for South Cambridgeshire has confirmed that they want to get rid of targets—in other words, he has confirmed that he does not believe that the Government should focus on the top priority issues for patients and the NHS by setting a target for reducing the MRSA rate.

Patricia Hewitt: I will shortly come on to the action that we have been taking, and supporting the NHS to take, to get the infection rates down, but the hon. Gentleman might find it useful and interesting to look at "Saving Lives: Our Healthier Nation", one of the pieces of useful guidance and support that we have been giving to the NHS to ensure that action follows the setting of targets.
	The Conservatives need to deal with this issue. If they really believe that targets should go, do they think that the NHS should be trying to halve MRSA rates by 2008, or not? Do they want waiting times to fall? Do they want cancer patients—people urgently referred by their GP because they might have cancer—to be got through their appointment with their specialist and their diagnostic tests, and to be started on their treatment, within 62 days? That is the target that we have set, and which has helped to transform cancer care in the past15 months alone. Do they believe that that target should be maintained and achieved, or do they not mind what the MRSA rates and the cancer waiting times are? In other words, are the Conservatives prepared to set national standards for the NHS and to ensure that they will be followed through, or will they give up, asthey did when they had their disastrous years in government?

Patricia Hewitt: The hon. Gentleman has indeed written to me about the tragic death of Mr. Martin, and I should obviously like to extend my condolences to Mr. Martin's family. Although it is never possible to eradicate MRSA completely, given the complexitiesof modern medicine, every avoidable death from MRSA—or any other hospital-inquired infection—is one death too many. That is why, as part of the clinical governance arrangements in the NHS that we have been strengthening since we were elected, it is essential that every hospital learns the lessons from any one of these preventable deaths—and, indeed, from every incident of MRSA or outbreak of C. difficile, even if it does not lead to a death. I am glad that the hon. Gentleman mentioned the new Romford hospital, which is one of more than 80 new hospitals that, under our Government, have been built or are in the process of being built for NHS staff and patients.
	I want to stress that even with 12 million people admitted to hospital every year, and such tragic cases as the one to which the hon. Gentleman has just referred, the risk of MRSA bloodstream infection remains very low, with fewer than two cases for every 10,000 hospital bed days. However, we also know that we can and must do more with all such infections. That is why in 2005 the chief nursing officer launched the national programme "Saving Lives", which was based on the best available information, guidance and practice from the UK and internationally. The programme was designed to focus the efforts of every hospital on a small number of high impact clinical interventions, and it has done so. All the evidence shows that if a hospital implements those measures consistently, it will reduce the rate of all those serious infections.
	Let me quote Peter Wilson, the consultant microbiologist at University College London Hospitals Foundation Trust:
	"Even though UCLH had high levels of MRSA bacteraemia in 2001, we have been successful in reducing them substantially by being focussed on the task and gaining the full support of the chief executive."
	He says that the trust has introduced
	"wound surveillance and rapid MRSA screening in addition to increased use of hand gel and hand hygiene education."
	He claims:
	"Any hospitals using similar strategies should be able to achieve the MRSA target. Antibiotic control has also ensured low levels of C difficile."

Patricia Hewitt: The hon. Lady is absolutely wrong. The system is not being watered down, as the success ofthe patient and public forums provides the basis for the much stronger system being put in place with the local involvement networks. We have been able to make an enormous difference to the quite shocking standards of hospital hygiene that we found when we were elected 10 years ago, precisely because of the work of patient environmental assessment action teams that go into hospitals and make unannounced inspections on behalf of patients and the public.
	Although all of our work—with "Saving Lives", the new screening guidance, the new code of practice, stronger powers for the Healthcare Commission and with the improvement teams—was having an effect, we remained unsatisfied. Infection rates for MRSA were falling, but not fast enough, so last month we announced a further allocation of £50 million in capital funding—[ Interruption.] The hon. Member for South Cambridgeshire should listen, as he was asking for more capital funding. That £50 million in capital funding was made available to enable hospital trusts to buy equipment and carry out work so that they could further improve hygiene and reduce the risk of infection.
	I can announce that, as of today, £45 million of that £50 million fund has already been released to trusts. They are using the money to build more single rooms for isolation treatment, to install more hand-washing basins and to modernise bathrooms, and to put in safe storage containers for dirty linen where they are needed. Trusts are also using the money to acquire new equipment for the heavy duty, deep steam cleaning of infected rooms and wards, and they are buying new wipe clean computer keyboards for theatres and new equipment for microbiology laboratories. Further investment in the national health service, made possible by the record investment that our Governmentare making in the NHS—investment that the Conservatives voted against—[ Interruption.] They do not like to hear that, but they will hear it. That investment would be put at risk every year by the Conservatives' new economic policy; they would cut funding for the NHS and other public services to pay for tax cuts.
	We know that getting infections under control has to be a top priority for the NHS, which is exactly what we said in the NHS operating framework for the next financial year. Cut infection rates, cut waiting times further, reduce health inequalities and achieve financial health—the top four priorities for the NHS for 2007-08. Those are all targets that the Conservatives would scrap. All those achievements would be put at risk by their health and economic policies.
	I commend the amendment to the House.

Patricia Hewitt: No, I am not intervening on the antibiotics issue, although that is an extremely important point and one that we have endorsed in the guidelines. Is the hon. Gentleman aware that in the Netherlands the rate of hospital acquired infections is about 7 per cent., and that in England it is about 8 per cent.? Although there are undoubtedly lessons that we can learn, and are learning, from our colleagues in the Netherlands, I deplore the fact that the hon. Gentleman is talking down the achievements of the NHS in that way.

Ann Widdecombe: As my hon. Friend says from a sedentary position, that is quite right too. I was not trying to deplore the measures that we take over foot and mouth; I merely wanted to translate them into the measures that we take with C. difficile and MRSA, and to suggest that we could be a little more focused.
	Certain things could be done, which are only being done patchily in the NHS, that should be standard practice. One of those is screening. The hon. Member for North Norfolk was absolutely right: screening is important.
	I have a tale of three hospitals. They are my own hospital, Maidstone, to which I am utterly devoted and for which I shall always fight but which, on this occasion, is causing me anxiety; the Royal London hospital in Whitechapel, London, to which my mother was recently admitted as a trauma case; and King Edward VII's hospital, a private-sector hospital also in London, to which she was transferred when the trauma had been stabilised. I watched the way in which those hospitals operated.
	When my mother went into King Edward VII's hospital, the reaction was immediate. A swab for MRSA had to be taken straight away. It was not a case of whether MRSA had been present in the Royal London. There could be no argument: she was coming into the hospital, and therefore needed a swab. For the 48 hours that elapsed before the swab proved negative, she was barrier-nursed. Everyone wore aprons and gloves and underwent a disinfecting procedure before daring to leave the ward, even if they went out merely to fetch a pen or some hospital gadget. If they walked out of the ward, full disinfecting procedures took place as if it were a foot and mouth area. That is effective screening. When the negativity of the swab had been established, the barrier nursing ended and ordinary nursing was substituted.
	In the Royal London the floor was so clean that you could see your face in it, and the nursing on the Helen Raphael ward was exemplary. I should add that it was an old-style Nightingale ward. The nurses sat at a desk at the end: they could see every single patient, and every single patient could see every single nurse. Everyone knew what everyone else was doing. The ward did not have those wretched little rooms behind the desk into which nurses often disappear, and from which they emerge very quickly when people come to look at the wards. It was a very disciplined, busy set-up. I think that discipline and nursing standards are crucial.
	The hon. Member for Crawley (Laura Moffatt) referred to "ward managers", but it is the ward sister who should be responsible for discipline on the wards. In Maidstone hospital, old people's drips are running out and not being replaced. Food is being put in front of old people and taken away again without any attempt being made to ensure that they eat it. Pills are being found in the dressing-gown pockets of patients because they have simply been handed over rather than being administered with supervision. There is some extremely sloppy nursing, and it is therefore not surprising that there is also infection.
	One patient sent me a video showing the amount of dirt in some of the wards. Before any Member puts his or her hand up and mentions contract cleaning, I should say that one example of that dirt consisted of a bowl of blood that had sat on a window sill for nearly 24 hours. It was not a contract cleaner's job to pick that up; it was, crucially, a nurse's job. It was the ward sister's job to notice that it had not been picked up, and her job to ask "Why is that drip not being filled?" or "Why is that patient not being fed?"
	One of my constituents telephoned his brother to say that he was in Maidstone hospital with C. difficile, sitting in his own diarrhoea, and that he wished he was dead. Can anyone believe that when that is the standard of nursing, it has nothing to do with the spread of infection?
	Screening is important, discipline is important, standards of nursing are important, and the ward sister's role is important. She is not a commissioner of blankets and bandages; she should be exercising discipline on the wards. The role of visitors is also crucially important. The hon. Member for Crawley told the story of the seven-year-old girl who went off to the loo. Was she not challenged, either going or coming back? Did no one ask "Have you washed your hands?", or say "You will make sure that you wash your hands, won't you?" Was she challenged by any of the nurses, by the ward sister or by any passing bearer of tea and coffee?

Ann Widdecombe: That standard of nursing is far too common across the NHS. I accept that it is not apparent in every ward. My hon. Friend the Member for South Cambridgeshire (Mr. Lansley), in his excellent introductory speech, pointed out that we can have two adjacent wards, one with no problem and one with a problem, and two completely different sets of practices. That is why I mention the ward sister. The ward sister and individual discipline on wards are utterly crucial.
	If it were simply Maidstone, I would say that something has gone badly wrong at that hospital, which clearly it has, but I get letters from all over the country from people who have similar experiences to tell about their local hospitals. While I would not dream of saying that it is so everywhere, it is certainly so in a greater number of places than it ought to be. Screening, hygiene, discipline, challenging of visitors, proper disinfection processes—those are not rocket science. They all make a tremendous difference to whether infection grows, or is contained and eventually reduced.
	No one blames the Government for the fact that C.difficile exists. It is not their fault. It is not the NHS's fault. It is not any individual hospital's fault when it suddenly occurs, but the reaction to it is the responsibility of Government, the NHS and the individual wards, and that reaction is not all that it should be. It should be standard practice that a swab be taken from every admission to the NHS. I know that it is boring but it should be done once a person is admitted to the wards. Full-barrier nursing should be provided until the swab has been shown to be negative. Care in isolation should be provided if the swab is positive. However difficult that may be, and it would be, I do not deny it, that should be standard practice—it should already be standard practice.
	It worries me—I think Florence Nightingale would have had a bit of a fit—that now one has to remind medical staff to wash their hands. It should be absolutely second nature. They should wash them more often. Most of us have observed medical staff moving from bed to bed, coming and going from wards and, not always, perhaps not even for the majority of time but quite enough of the time, forgetting to wash their hands. That is not rocket science either. Therefore, if common sense were applied instead of statistics, we could make a serious difference, at not particularly great cost, possibly at rather a lot of inconvenience, but it would be worth it.
	I have had elderly patients die in Maidstone hospital who probably need not have died, whose relatives cannot forget what they saw. I have had recounted specific descriptions, including an occasion when a patient, and it was observed, rang a bell in the middle of the night for 15 minutes and was not answered because all the nurses on the ward were at coffeebreak at once. Rocket science? Discipline and the ward sister.

Michael Penning: It is a privilege to follow my right hon. Friend the Member for Maidstone and The Weald (Miss Widdecombe), who spoke so much common sense. We have had an interesting debate, and I do not want to dwell on statistics and bore Members by talking about numbers. However, I desperately want to look at one area. In common with many Members, constituents of mine have died from MRSA—methicillin-resistant Staphylococcus aureus—and C. difficile in local hospitals, but I want to talk about the many patients who have not died, but who have suffered whatthey almost feel is a worse outcome, that of losing their legs.
	Let me give the example of a constituent I met shortly after the last general election. The gentleman had been involved in a serious car crash and he had extensive neck, head and shoulder injuries, but he had no problems at all with his legs. He had steel plates inserted in theatre and was in intensive care for a considerable period. When he went on to the wards to recover, he was tested for MRSA; he was found to have it and subsequently lost both of his legs. That highlights the daily effects of having that kind of infection in our hospitals. Like my right hon. Friend, I do not blame the Government for the existence of such infections—I do not think that anybody would dream of doing so—but what is important is how we react to this situation.
	I have a question for the Minister—have any modelling or other studies been done on the effects of contract cleaning and in-house cleaning? As the Minister knows, I am a trade unionist, and the point contained in my question is often thrown up by Unison and other such bodies representing their workers. Their representatives say, "The problems arise because we have contract cleaning." I am a member of the Health Committee, and in that capacity I have visited hospitals using contract cleaners that are immaculately clean and hospitals cleaned in-house that are also immaculate; but, frankly, in my area of Hertfordshire there are also filthy hospitals that are cleaned by contract cleaners and filthy hospitals that are cleaned by in-house cleaners. It must be the job of the Secretary of State and her Department to set standards so that the whole country is on a level playing field. Like many Members, I was disappointed to hear this afternoon the Secretary of State yet again avoid responsibility.

Michael Penning: My hon. Friend is a former nurse and she brings a whole education to this House in terms of understanding what goes on in hospitals. My mother was a nurse for 40 years. Florence Nightingale might be turning in her grave, but my mother turns incessantly because of nurses and doctors who do not do things such as wash their hands. I will come on to cleanliness and the mopping situation shortly.
	I want now to discuss an issue that my right hon. Friend referred to—discipline. I recently visited my hospital and I was introduced a modern matron. I asked that modern matron what she did and she replied, "I manage." I inquired whether she managed a ward and she said, "No, no; I manage lists and things." That shows why the Government's target culture is so wrong and why targets should be abolished. Instead, standards should be set throughout the NHS for what is right and what is wrong—what is good practice and what is bad practice.
	Let me give the Minister a prime example of good practice across the board combined with discipline that is working very well. If the Minister were as lucky as I am, he would have had the pleasure of visiting the field ambulance unit in al-Amara in Iraq. It is made up of regulars from the Royal Army Medical Corps and other services, but also of Territorial Army members of our armed forces, of whom we should be very proud for augmenting our forces. Most of those TA members are doctors, nurses and technicians who have come from the NHS. They work in the NHS in everyday life, but they are currently in Iraq serving our armed forces.
	The Minister can correct me if I am wrong, but in the three years that that field ambulance unit has been in place, there has been not a single case of MRSA among our armed forces there, nor among those of the local population who were treated there when they needed acute care. Why is that? Part of the explanation is clearly that the bed occupancy rate is very low. Patients are not being rushed into a bed within minutes—sometimes, it literally is minutes—of its being vacated. Also, cleanliness is the responsibility of the ward sister and of the nurses in that field hospital. Those same nurses also work for our NHS in this country. I have met them and they want to provide the best possible care; they want to put a rocket up cleaners who are not doing their job, but they are not allowed to. However, when they are working in the military, they naturally have the backing of rank and of the armed forces. As we have heard so many times today, keeping our wards clean daily is not rocket science.
	Many years ago—it must have been 1972, given that I joined the Army in 1974—I volunteered to work on Saturdays on the geriatric unit, as it was called in those days, that my mother worked on in the Rochford hospital in Essex. I saw nearly every Saturday what we would now call spring cleaning—the hospital called it Saturday cleaning—where nurses and cleaners worked together and blitzed the ward. Patients who could leave their beds did so, and everything was cleaned until it was spotless. I cannot remember the last time I saw a nurse do that sort of cleaning. That is not because they do not want to—by the way, if it is, they should do it anyway—but because of the pressures in the NHS today and the different nursing methodologies, which simply involve passing the drugs around, for example. It is not that our NHS does not care. Far be it from anyone in this House to say that people join the NHS for any reason other than to serve their communities; they certainly do not do it for the money. They do it because they care, but bit by bit, the view that the patient must come first and bureaucracy second is somehow being knocked out of them.

Michael Penning: I could not agree more with my right hon. Friend. In my armed forces days, those who walked around with a clipboard were usually left alone because they were not doing anything. We do not want people with clipboards; what we need is for wards and beds to be cleaned efficiently, so that we can get to grips not only with MRSA, but with C. difficile and other infections. Given the information in the Government's leaked documents, there is no doubt that through targeting just MRSA, efforts to deal with other dangerous and critical infections have unintentionally fallen by the wayside. I do not think that the Department said, "We'll let C. difficile explode out of all proportion,", but it took its eye off the ball by going down the avenue of targets. As the experience of my local hospital structure shows, if one thing is targeted, something else gets forgotten because the system simply does not have the capacity to cope.
	I shall not dwell on what I saw in my hospital the Friday before last, when I visited a friend who has since sadly died, but I will point out that I saw a ward full to bursting and a mixed-sex ward. That, in the 21st century, is degrading, and the Government promised that it would not happen. No more than 20 ft from the ward that I visited was another ward that was empty not because it was infected, but because there is no money to staff and run it. Frankly, the south-east gets a particularly bum deal when it comes to NHS funding. The Secretary of State knows, because I go on and on about it, that this is an issue in my general hospital, which is about to be closed. I will defend that hospital and its nurses to the hilt. We have to have the capacity that allows cleaning to take place in the short period during which beds can be cleaned properly, for example.
	My hon. Friend the Member for Mid-Bedfordshire (Mrs. Dorries), who probably has much more experience in nursing than all the Government Front Benchers put together, raised the very important issue of wet-mopping, which we used to call "grind it into the ground" mopping. I do not know whether anybody has noticed this, but wards tend to be rectangular—they have corners. However, the cleaning process involves the use of circular electric mops that cannot get into the corners. Bit by bit, the dirt and muck gets thrown into the corners, and unless someone is willing to get on their hands and knees, the dirt will not be cleaned out. When wet-mopping was done, that was not a problem because mops can get into the corners. Of course, even with wet-mopping people could be complacent and not use hot water or the right chemicals, but at least it was possible to see what was going on; now, often it is not.
	Has there been any indication of the cost to the NHS of litigation arising from cases of hospital-inquired infections? The Minister said that the Government recently invested £50 million to help deal with hospital-inquired infections, £45 million of which will be used immediately. I should be interested to know whether any of that has gone to West Hertfordshire Hospitals NHS Trust. I should be very surprised if it has, but perhaps he could write to me and let me know. The cases where those who have acquired these infections have gone down the litigation route must be costing the NHS an absolute fortune. In the long run, it must be cheaper, and morally and ethically preferable, to clean the wards properly rather than paying lawyers a fortune.

Daniel Kawczynski: The other Minister of State who is present, the hon. Member for Don Valley (Caroline Flint), is barracking me from a sedentary position, as is her custom. Surely we should listen to our constituents, especially when they have long experience of working in the NHS.
	Mrs. Davies has offered me a number of suggestions, which I want to pass on to the Minister who will wind up the debate. First, no indoor uniform should be worn outside the hospital. Changing facilities should be provided, and that strict rule must be adhered to. Secondly, nurses should be made to wear a disposable apron when in contact with patients. That is the practice in Europe, so why not here? It is obvious that disposable aprons should be used when a nurse comes into contact with a patient, and then disposed of immediately afterwards.
	Thirdly, Mrs. Davies says that spot checks on thick uniforms should be carried out, to find out what types of bacteria are growing there. In addition, doctors should wear white coats over their suits. Fourthly, visitors should be supervised, and they should not be allowed to sit on beds. There should be no more than two visitors to a bed, and patients should not sit on other patients' beds.
	When I was recently in the Royal Shrewsbury hospital's maternity unit awaiting the birth of my first child, Alexis, I saw an awful lot of people sitting on beds, and there were far more than two visitors per patient. I mean no criticism of the hospital: the nurses are so overstretched that they do not want to keep going on about people sitting on beds. It is something that the Government should communicate to the general public. The Government spend millions of pounds on putting socialist propaganda on television, which they say is public information—but why dothey not talk about MRSA, or other important matters? They should tell people that they have a responsibility to act correctly when they visit relatives in hospital.
	Mrs. Davies' fifth point is that paper carries infections, so patients should not share newspapers or magazines. She is right about that, but the maternity ward was full of magazines that people passed around. There should be much stricter guidance about newspapers and magazines in hospitals, as Mrs. Davies assures me that MRSA can be carried by paper.
	Mrs. Davies' final point has to do with cleaning, and the need for wards to have domestic supervisors. When wards are cleaned, the clutter that gathers around beds is not moved, but that problem could be overcome if a ward sister were on hand. My right hon. Friend the Member for Maidstone and The Weald (Miss Widdecombe) has often spoken about the need to have matrons or ward sisters in hospitals, and the Minister should take heed.
	The RSH is more than £30 million in debt, as the Minister will know. People are very worried about the focus on debt reduction, and the problem is now so bad that charges for car parking are not confined to members of the public who use the hospital. Under this socialist Administration, nurses are being told that they will have to pay to park their cars when they come into work —[ Interruption. ] The Minister may laugh, but that is the reality.
	The hospital has set up all sorts of schemes to raise money to deal with the debt. Charging nurses to park their cars is one such scheme, but another is to charge the hospital's league of friends for operating its charity shops in the hospital. I and other Shropshire MPs have regular meetings with the hospital's chief executive, Tom Taylor, and the focus is always on finance and how the huge debt can be reduced. That approach worries me, because it lessens the attention given to problems such as MRSA.
	When my daughter Alexis was born—on Trafalgar day—I was extremely impressed with the cleanliness of the RSH's maternity ward. However, the staff are very overstretched, and although I shall not go into the details now, I would be happy to write to the Minister about what I saw in the three days that I spent waiting for my child to be born.
	As I noted in an intervention on the hon. Member for North Norfolk (Norman Lamb), 16 beds are to be cut at the RSH maternity ward between now and February. On top of that, the hospital in nearby Oswestry is to lose its maternity services completely. As a result, there will be even greater pressure on the RSH's maternity services. I fear that the cuts mean that people will take their eye off the ball, and the high standards of our maternity services will not be maintained.
	All those things are part and parcel of the Government's attempts to take a one-size-fits-all approach to maternity services. In Shrewsbury a woman stays in hospital after giving birth for 2.6 days, on average. The hospital has won so many national awards that staff are repeatedly asked to come to the House of Commons to give evidence to the Health Committee about their great achievements, yet outside consultants have now told them that a stay of 2.6 days is far too long, and that they should aim for the national average of one day. That is a scandal. I am concerned about that situation, and about the impact of the cuts on dealing with MRSA.

Andrew Murrison: My hon. Friend makes a very good point, which demonstrates the importance we attach to this issue. His remark underscores how important it is for us. It is a pity that Government Members do not think it at all important, as evidenced by the fact that only one of their Back Benchers managed to turn up to make a contribution.
	What account has the Minister taken of the hospital-acquired infection record of non-NHS hospitals, and are there any lessons to be learned from it? I make no particular judgment, but the record in some non-NHS hospitals is clearly better than in some NHS hospitals, so it would be foolish not to study it carefully and learn whatever lessons are to be learned. I would be interested to hear whether the Minister has reflected on the difference between the two and on what might be done to improve the record in the NHS as a result.
	I am quite convinced that what is actually important is that ward staff must be comfortable with the management tools to direct cleaning staff, that cleaning staff should feel that they are a full and valued part of the health care team and that senior nurses should have access to them 24/7. We often go around hospitals, and it seems to us that cleaning staff are not seen as full and active parts of the health care team—well, they are, and they must feel that they are—and I am very sorry that the Secretary of State's amendment eschews our mention of health care staff. That is a pity, and I hope that it is an oversight. Mention of ancillary staff is long overdue, and I hope that, in reparation, the Minister might mention their contribution to cleanliness in hospitals.  [ Interruption. ] If the hon. Member for Livingston (Mr. Devine) would like me to give way, I should be more than happy to hear his remarks.
	My hon. Friend the Member for Leominster (Bill Wiggin) is right to be concerned about innovation and the fact that it has been introduced far too slowly. The rapid review panel is apparently not rapid, according to a frustrated innovator, called Air Science, which has contacted a number of right hon. and hon. Members. It says that
	"it is ineffective in meeting its aims and by not encouraging further research of the most promising applications it is an obstacle to progress."
	The main block appears to be the rapid reaction panel's level 2 assessment, which involves the ability to gain support for the translational research and development which enable small companies of the sort that Air Science evidently is to front up the innovation that the health service needs to tackle health care-acquired infection. A level 2 innovation is promising, but crucially, has not yet been proven in an NHS hospital setting. Most companies struggle to afford the means to provide such proof and they need help with it. Air Science concludes by saying:
	"Clearly there is great scope for new initiatives. To find them was the intended role of the RRP. It is instead proving a barrier to progress, not its catalyst."
	The onward march of Clostridium difficile has underscored the need for restraint and discernment in the prescribing of antibiotics. Four times as many people die in the UK from that health care-acquired infection as from MRSA, and conventional cleaning and hand washing will not necessarily help that much—a different approach is needed. What is the Minister doing to ensure best practice in universally applying the lessons available from best performance in the NHS and to ensure that they are learned by outriders? It seems that he is doing precious little, judging by the absence of a reference to Clostridum difficile from the Government amendment.
	The hon. Member for North Norfolk (Norman Lamb) made a very valuable contribution. He rightly talked about antibiotics. He should also have talked about—we might have done as well—instrumentation that introduces infection, such as intravenous cannulation and other things, as that has been the subject of much debate recently and of comment by Professor Hajo Grundmann of the National Institute of Public Health in the Netherlands. It is very important that we consider minimising such interventions in our fight against health care-acquired infections.
	The Secretary of State for Health mounted a robust defence of the national MRSA target set in 2004, saying that, in its absence, less progress would have been made. Will the Minister say when he will set up a comparable target for Clostridium difficile, because that is the natural extension of what the Secretary of State said? The Secretary of State's defence of local targets was based on a false assertion that it is a local problem—well, it clearly is not, as is made very clear by the comment from her own Department that it is endemic.
	The hon. Member for Crawley (Laura Moffatt) and my hon. Friend the Member for Shrewsbury and Atcham (Daniel Kawczynski) rightly talked about staff. The Government amendment removes any mention of staff from our motion, which is a pity, and I hope the Minister will explain that. From the Royal College of Nursing 2005 "Working Well" survey, we learned that the number of nurses with access to changing facilities dropped from 61 per cent. in 2000 to 50 per cent. in 2005, and that only 39 per cent. of nurses have access to showering facilities at work. Just 35 per cent. of hospital-based NHS nurses said that their employer provides a uniform laundering service. Is that any way to treat a profession that is doing its utmost to reduce health care-acquired infections? What message does it give to those who are entering the profession aboutthe significance attached by management to basic standards of hygiene?

Andy Burnham: I welcome today's debate, because it deals with an issue to which this ministerial team attaches the highest possible priority: patient safety and public confidence in our national health service. It gives us an opportunity to say very clearly on the record that MRSA infection is falling in our NHS, despite what others might seek to claim. However, there is absolutely no complacency whatsoever among Labour Members, and I will set out some of the measures that the Government are taking.
	While sitting through this debate, I have heard more bar-room garbage emanate from Opposition Members than perhaps I have ever heard before. Yesterday, they pledged to abolish targets and end top-down Government action in the NHS. [Hon. Members: "Hear, hear."] The call was to keep politicians out of health care andthe NHS—a big, principled call. Today, they bring us to the House to demand no less than six-monthly reports on Government action to tackle health care-acquired infections. Yesterday, they committed themselves to scrapping our MRSA target. Today, they put before us what seems like a target for the number of washing machines in NHS trusts.

Andy Burnham: It is important to say that the trajectory for cases of MRSA at that trust is 49. The actual figure is 47. The rate of improvement is better than the target. Yes, there are issues about C. difficileat the trust, but we have asked the Healthcare Commission to look at them, as has the strategic health authority. I am sure that the commission will come back with its findings shortly.
	Many hon. Members raised the issue of staff uniforms. It is important to say that there is no real evidence that uniforms or work-wear are a major source of cross-infection. However, I accept the point made by Opposition Members that it might be an issue of public confidence and a question whether people believe that there is an adequate hygiene policy in place. In the light of that concern, a review of current uniform policy has been taking place. Its conclusions will be available shortly.
	Concerns were raised about the £50 million fund. The hon. Member for Hemel Hempstead (Mike Penning) raised that issue in relation to his trust. Announcements will be made in due course.

Madam Deputy Speaker: We now come to the second Opposition debate on the life chancesof disabled children.  [ Interruption. ] Members not wishing to participate should leave the Chamber as quickly and quietly as possible. I remind the House that Mr. Speaker has selected the amendment in the name of the Prime Minister.

Jeremy Hunt: I beg to move,
	That this House notes the plight of the UK's 570,000 disabled children and the 55 per cent. of their families who are living in, or on the margins of, poverty; further notes with concern the Children's Commissioner for England's view that services for disabled children are a 'national scandal'; acknowledges thelink between disability and child poverty; believes that the Government's target of halving child poverty by 2010 and eradicating it by 2020 will not be achieved without a strategy that seeks to improve the life chances of disabled children; welcomes the interest in short breaks for families with disabled children shown by the hon. Members for Normanton and Devon South West in their previous and proposed private members' bills and looks forward to the Government's response; believes that the current system of assessment and support provided for families with disabled children is complicated, bureaucratic, costly and stressful for both disabled children and their parents; further believes that the complexity of the benefit system acts as a barrier to employment for parents of disabled children in a way that prevents social mobility and entrenches poverty; and therefore calls on the Government to build on legislative progress on disability issues made under this and previous governmentsby simplifying the assessment processes and reducing the complexity of the benefit system for families with disabled children in order to prevent disabled children and their families being trapped in poverty.
	It has been said that
	"services for disabled children and their families are a national scandal".
	Those are not my words, but the words of the Children's Commissioner for England. That is shocking, as there has not been a lack of good intentions on the Government's part, or a lack of legislation, or a lack of willingness to invest in services, as evidenced by the Carers and Disabled ChildrenAct 2000, the Special Educational Needs and Disability Act 2001, the 2003 Green Paper entitled, "Every Child Matters", the Children Act 2004, the life chances report of 2005, the Disability Discrimination Act 2005 and, last year, the Treasury policy review of children and young people, which reported its interim findings this month. I could go on, and it is hard to disagree with anything that the Government say in those reports. However, there has been a failure to deliver meaningful change to the lives of hundreds of thousands of families with disabled children.
	A recent parliamentary inquiry chaired by the right hon. Member for Coatbridge, Chryston and Bellshill (Mr. Clarke) and the hon. Member for Blackpool, North and Fleetwood (Mrs. Humble) found that 81 per cent. of parents with disabled children rate social service delivery as poor, and that 52 per cent. rate the delivery of educational services as poor. When it comes to disabled children, it is clear that not every child matters.

Jeremy Hunt: The source of that figure, I am happy to tell the right hon. Gentleman, is the interim findings of the Treasury's policy review on children and young people, which quotes that as the number of children who qualify under the Disability DiscriminationAct 1995, but the life chances report refers to 272,000 disabled children, so there is obviously some doubt as to the precise number. On average, it is clear that one in 20 children has a significant disability.

Jeremy Hunt: My hon. Friend makes an important point. I know that she knows a great deal about the matter. I shall deal with the lack of respite care later in my remarks.
	With reference to the forms, it is worth pointing out the number of complaints made by parents of autistic children about the inadequacy of the DLA, and in particular its inadequacy in identifying non-visible disabilities. There is no question on the DLA form that asks, for example, how many times the child ran away last month, but that is the kind of challenge with which parents of autistic children have to deal. It is clear, and I am grateful to my hon. Friend for highlighting it, that we need much greater awareness of conditions such as autism in the working of the benefits system.
	It might be suggested that the reason why we ask parents 1,118 questions is that disabilities are complicated and we need to understand the facts, but 23 questions are repeated on every form, three quarters of the questions on the forms are repeated at least twice, a third of the questions are repeated at least three times, and a quarter—that is 274 questions—are repeated at least four times. Perhaps that is because they apply to different Government Departments. Let us quietly forget the Prime Minister's comments to the civil service conference in 1998 about
	"joined up policy making for joined up services".
	However, six of the eight forms are from thesame Department—the Department for Work and Pensions.
	The result of the complexity is very low take-up of benefits. The Child Poverty Action Group estimates that about half of parents of disabled children claim DLA. The survey by the Child Poverty Action Group and Contact a Family showed that a third of parents are put off claiming DLA by the complexity of the form.

Jeremy Hunt: I am interested to hear that response from the Minister. Perhaps she would like to know why I asked that particular Parliamentary Under-Secretary of State at the Department for Education and Skills how many times he had attended meetings of the Office for Disability Issues. It was because of a response that the Minister herself had given me in answer to a parliamentary question about which Ministers were members of the ministerial oversight group.

Anne McGuire: As the hon. Gentleman supports a bicameral system in Parliament, he may be aware that there is more than one Parliamentary Under-Secretary of State in the Department for Education and Skills; the other one is a Member of the other place.

Jeremy Hunt: We asked the Parliamentary Under-Secretary of State in this place, and we got a reply from the Parliamentary Under-Secretary of State in the other place. So we have been in touch with both of them, and there does seem to be some confusion over the issue.
	A further group of people who are severely short-changed by the way in which we look after families with disabled children are the taxpayers. As taxpayers, we want to help families in that incredibly vulnerable situation, yet we see that of the £5.4 billion that is spent supporting such families through the social care budget, £1.1 billion—26 per cent.—is used up by the assessment and commissioning process. That money does not go towards providing the services that the families need. We have also discovered that, according to parliamentary answers on the administration of the disability living allowance, £630 million was lost through official error. About£360 million was lost through official error relating to housing benefit, £110 million through official error relating to income support, and £10 million through official error relating to the carer's allowance.
	One third of the families who have access to short breaks say that their access has been cut over the past year, and eight out of 10 families say that they are at breaking point due to the lack of access to short breaks.

Jeremy Hunt: I warmly commend my hon. Friend for bringing that issue to the attention of the House. Why cannot the Government look into the possibility of reforming and streamlining the assessment and commissioning process, so that funds could be found to finance the important respite care that my hon. Friend has described?
	I mentioned earlier that a major consequence of our failure properly to support families with disabled children is a lack of progress on the child poverty targets. We know that more than half the families with disabled children live either below the poverty line or on the margins of poverty. We also know that disabled children are twice as likely as other children to be receiving free school meals. The Government's strategy on child poverty has essentially been based on income transfer and on ensuring that vulnerable families have enough money in their pockets to buy what they need to live on. I want to adapt a well-worn phrase to suggest to the Government that, as well as being tough on poverty, we need to be tough on the causes of poverty. That means looking not only at income transfer, but at removing the barriers to social mobility. The complexity and bureaucracy of the system prevent social mobility at the moment.
	I spoke to the mother of a disabled child recently, and she told me that she earned £2 a week more than she was allowed to on the carer's allowance—the limit is £84 a week—and that she was now being asked to repay £1,600, which of course she does not have. I remember the parent who spoke to the parliamentary inquiry and described how having to juggle 21 professionals made it impossible for her to think about work. I put it to the House that the role of social mobility in combating poverty is one of the main areas of difference between ourselves and the Government. We all support the aspirations of the child poverty targets, and I urge the Government to look at the role of social mobility as they review their child poverty strategy.
	The policies that we adopt on families with disabled children must be central to social policy because itis about the family. A health society has healthy families—social breakdown occurs when we have family breakdown. There is much that is wrong with our support for families with disabled children, but perhaps the thing that is most wrong is the poverty of ambition in regard to what can be achieved. Some people say that there are no heroes any more, but every hon. Member knows that the true heroes and heroines of our time are the parents and carers of disabled children. They want nothing more than to focus all their energy, attention and efforts on bringing up their much-loved children. Instead, we make them battle against the system. Let us scale up our ambition and give them a system worthy of their great efforts.

William McCrea: Last week, the BBC alerted my constituents to the fact that more than 100 young people with profound learning disabilities have been kept in Muckamore Abbey hospital, and have not been able to get out into the community, because there is no care in the community available or place for them to go. It also found that20 young people are in locked-up wards in that hospital, when there should not be locked-up accommodation at all. Surely something ought to be done about that.

Angela Watkinson: May I commend to the Minister the ROSE—real opportunities for supported employment— project at Havering college of further and higher education, which helps students with learning difficulties into work? It is highly successful, and an example of good practice that could be copied throughout the country. The main difficulty is not finding employers who are sympathetic and willing to take on such students, nor is it persuading the students to take on jobs, because they are keen to do so. The main difficulty is that parents are worried about losing benefits if their children work for more than16 hours a week. That is a problem that we could easily overcome.

Anne McGuire: I have not seen the hon. Gentleman's initial parliamentary question, but I say to him and to Conservative Members that Lord Adonis has attended meetings of the cross-ministerial— [Interruption.] He has. As I say, I have not seen the original question that the hon. Gentleman sent. The Under-Secretary of State for Health, my hon. Friend the Member for Bury, South (Mr. Lewis), says from a sedentary position that it certainly was a real person, looking like Lord Adonis, who attended those meetings. I think that that is an issue that would be better resolved in another place. I want to give the hon. Gentleman an assurance that we are taking this very seriously. Ministers are taking it seriously.
	I will now look at some of the points that the hon. Gentleman made about benefits. We recognise that sometimes benefits and the procedure for benefits can be a barrier. That is why we are constantly investigating ways to improve our benefit delivery. We are working with the Child Poverty Action Group, Contact a Family, family and carers groups, and the Disability Rights Commission to examine how we can make the operational changes that will make the reaction to applications for disability living allowance for children more responsive. We are working with various other stakeholder groups on that issue.
	I also want to say to the hon. Gentleman that we have made significant changes in the amount of benefit that is paid to children. I do not want to scratch over old sores, but in 1997 children under the age of five could not apply for the mobility component of the disability living allowance. That was a rule made by his Government. We changed that, and now children can apply from the age of three. This is not old hat, and it is part of the reason why sometimes there is an element of shallowness in the way in which some hon. Members—excluding the hon. Member for South-West Surrey—come to the issue. In fact entitlement now to disability living allowance can start at the age of two yearsand nine months. The disability child premium has doubled since 1997, and the carers premium has also doubled.

Russell Brown: I forgive the Minister for whatever she said there—I do not think it was derogatory. Hon. Members on both sides of the House would agree that the needs, wishes and desires of disabled people are complex. The hon. Member for South-West Surrey (Mr. Hunt), who speaks on behalf of the Conservatives, has talked about the amount of paperwork that needs to be filled in. I noted the article in  The Times yesterday and I have also looked at the Conservative website. There appears to be a move towards reducing the number of benefits, but I am deeply anxious. I do not know whether the Minister shares my concern. Does shenot believe that rolling up all the benefits available to disabled people would create a more rigid system that would not be able to meet the diverse needs of disabled people?

Anne McGuire: I do not wish to be discourteous to the hon. Lady, but in fairness to other Members I should try to draw my remarks to a close.
	The review by the Treasury and the Departmentfor Education and Skills—with support from other Departments, including mine—found that many programmes and initiatives are making a real difference, and that there is widespread good practice in delivery for disabled children and young people. However, as I said at the beginning of my speech, we recognise that that good practice is not yet consistent across the country. There are also a number of areas where more work needs to be done: ensuring that information on benefits gets to parents and carers at the right time—a point that was made by the hon. Member for Edinburgh, West (John Barrett)—improving knowledge and understanding of disabled young people, and disabled people generally, in the work force; developing a coherent and clearer understanding of the disabled children population; and further integration and co-operation between services. I hope that, through the Office for Disability Issues, we engage in joint working across government.
	Let me say something in a spirit of solidarity with the hon. Member for South-West Surrey: we all want the best for our children and for the next generation of young people in our country. This Government have committed unremittingly to giving disabled children and young people the right start, the right opportunities and the right support, to ensure that they have abright future. Every child matters, and every disabled child matters—and although we might have differences on the approach to be taken, I hope that the hon. Gentleman will reflect on his party's motion and decides that some of the comments are rather harsh in thelight of our record. I ask the House to support the amendment.

Danny Alexander: That is right—and to me, as someone who will, God willing, in due course be welcoming an additional member to my own family, it is also particularly important.
	Charities estimate that it costs three times more to bring up a disabled child than it does to bring up a non-disabled child. In the UK, 3.6 million children are living in poverty—that is, 28 per cent. of such children—compared with 55 per cent. of disabled children who are living in, or on the margins of, poverty. It is important to recognise that poverty is not only likely to result from disability, but that it also might cause it. For example, children born into low-income families are more likely to have low birth-weights, which can lead to future health problems. The interrelationship between childhood disability and poverty is clear, and so are the consequences of that for the services that people consume.
	Of families with a disabled child, one in 13 receives support from social services departments. Disabled children are 13 times more likely to be excluded from school than non-disabled children, and eight out of10 families with disabled children say that they are "at breaking point".
	So the clearest indication that disabled children do not have the same life chances as non-disabled people is the extent of poverty faced. Only some 6 per cent. of families with disabled children reported that they were "comfortably off". By way of contrast, 92.8 per cent. reported experiencing some kind of financial difficulty. It is important to talk a bit about the causes of such poverty. I shall come back to the extra cost of services, but there is also the question of the extra cost of living. Let us consider fuel poverty. Disabled children might have particular needs in terms of keeping the house warm, so turning down the heating, which many people are encouraged to do, is not an option. That expense simply has to be met, leading to greater fuel costs for the families of disabled children than those experienced by the general population. The proposal to extend the winter fuel payment to severely disabled people would therefore have some impact in this regard.
	There are a number of inadequacies in the benefits system, to which I shall return, but in addition to that issue and the cost of services, the other big barriers for families with disabled children are the barriers to work. This issue is not adequately addressed in the Welfare Reform Bill, and we perhaps need to return to it. For example, social care services, to which the hon. Member for South-West Surrey referred, often assume that parents can pick up any additional hours that such services cannot provide. That obviously impinges on parents' ability to work, especially full time, because there might be an unexpected requirement to provide care for their child when the system lets them down, thereby removing them from the workplace. That is reflected in the fact that only 16 per cent. of mothers with disabled children are in work, only 3 per cent. of whom are in full-time employment. By way of comparison, 61 per cent. of mothers of non-disabled children are in work. That is a huge disparity.
	Let me give a quotation from the "Every Disabled Child Matters" campaign. One mother of a disabled child said that
	"simply getting out of the house can be difficult. I spend all my time organising his different appointments. I used to work as a radiographer in the local hospital. I really enjoyed my job but I can't imagine I'll ever be able to go back, I'd never find the right childcare."

Danny Alexander: I certainly do share that concern. I had not intended to highlight it, but I am grateful that the hon. Lady has.
	The poverty and worklessness figures are even more worrying in cases where there is a disabled adult in the house, as well as a disabled child. According to the Department for Work and Pensions,
	"a household with a disabled child and a disabled adult is nearly twice as likely to have a low income"
	as a household with no disabled family members. That throws into stark relief the poverty-related problems that disability can often cause. According to the charity Working Families, 70 per cent. of parents with disabled children find it difficult to obtain appropriate child care. By definition, therefore, only 30 per cent. can find appropriate child care, which affects their ability to work as well as, importantly, the well-being of the child.
	The Liberal Democrat approach to these issues was set out very clearly by my right hon. and learned Friend the Member for North-East Fife (Sir Menzies Campbell) in his major speech on poverty in December. Like the Minister and the hon. Member for South-West Surrey, we have committed ourselves to supporting the target to eliminate child poverty by 2020. There has been a welcome reduction in child poverty under this Government but it has yet to go far enough, which, of course, is why the interim targets have been missed. For the reasons that I described earlier, tackling poverty among disabled children is now critical if the 2020 target is to be reached. We need a different approach. We need to move away from the mass-means-tested, complex and bureaucratic dependency system that we are increasingly seeing under this Chancellor of the Exchequer.
	Given the article in Monday's edition of  The Times, I, like the hon. Member for Dumfries and Galloway (Mr. Brown)—he is no longer in his place—had hoped that we might hear a little more from the hon. Member for South-West Surrey about the Conservatives' plans for reform. He was long on criticism, some of it legitimate, but there were zero policies for dealing with the reasons behind such criticism. It is a shame that the hon. Gentleman is hiding his light under a bushel. If the article in  The Times is to be believed, he and the hon. Member for Bury St. Edmunds (Mr. Ruffley) have submitted a lengthy policy proposal to a particular working group. I am surprised that the hon. Member for South-West Surrey did not take the opportunityto extol the virtues of that proposal. Perhaps thehon. Member for South-West Bedfordshire (Andrew Selous), who will wind up for the Conservatives, will do so. It is important in these debates not just to highlight problems, but to describe solutions if one can.
	In the absence of such efforts, one has to go back to the speech of the right hon. Member for Witney (Mr. Cameron). He looked at poverty issues more generally, and described an approach based on
	"rolling back the frontiers of society".
	That is not so much a big idea for the future as a small idea from the past—an approach that my right hon. and learned Friend the Member for North-East Fife referred to as one of "compassionate inactivity". In the absence of hearing more from the hon. Member for South-West Surrey, we have to assume that that is what he has in mind.
	There are some big issues to do with how the benefits system affects disabled people. I shall highlight one or two examples of the real experiences that disabled children and their parents have of the benefits system. According to the Child Poverty Action Group's "Out of Reach" report, some 46 per cent. of parents of disabled children
	"believe that they have missed out on benefits and tax credits because they have not been told they could apply".
	That is nearly half. Some 43 per cent. of parents of disabled children had not claimed disability living allowance or it had taken more than two years to find out that their child could be entitled to it. Those issues relate to both the adequacy and the complexity of the benefits system.
	On the issue of adequacy, the Minister made some fair points about the rising levels of benefit in recent years, but it is also true to say that the levels of most benefits have been progressively eroded in recent years.

Joan Humble: The hon. Gentleman is absolutely right. When I talk about the transition from children's to adult services, I do so because our services have age limits applied to them—and they can be arbitrary, particularly when we are talking about people with disabilities. As the hon. Gentleman so rightly says, some 19-year-olds with disabilities are, to all intents and purposes, children, while others of the same age may have high intellectual abilities. They may have a physical disability, but be more than capable of dealing with the world of work or the world of further or higher education. One of the key messages that should come out of our debate is that we must take account of individuals. Everyone is an individual; we are all individuals. A young person with a disability is most certainly an individual and should be listened to on that basis.
	For that reason I welcome the Government's£13 million investment in the early support programme pilot, which has produced some very good work. A further £27 million has been invested in children's hospices. Brian House children's hospice is in my constituency, so I know that it does excellent work. I thank the Minister for what she has provided, but I would add a brief postscript of "more please". That investment has also been matched by a huge increase in expenditure on education.
	Key questions nevertheless must be asked. Is there enough money in the system? Is it being spent in the right way and is it going to the right people? Are the Government's excellent policies being implemented and are they changing people's lives? When I hear Ministers tell us how much money has gone into the system, I accept it, but I hear from my own constituents—and some Members heard from the parents at the parliamentary hearings—that they often do not see much evidence of it. We therefore need to look more closely into where the money has gone and why some families clearly have difficulty accessing the services that they need. The hearings clearly showed that a family with a disabled child is more likely to be poor, more likely to face barriers to work and barriers to the enjoyment of the many everyday things that we take for granted—holidays, visits to the cinema, visits to the park and so forth. What those people wanted more than anything was to live ordinary lives, to be socially included, to have equity in services and support.
	Poverty and the additional costs of disability put enormous pressure on families. A Contact a Family survey of 2004 showed that only 6 per cent. of disabled families reported being "comfortably off", with92.8 per cent. reporting some form of financial difficulty. The support that families need to improve the life chances of disabled children is not just about appropriate care, education or housing; it is about improving the family income, jobs and the child care provided by well trained individuals who understand the needs of their disabled children. It is a hugely complex issue.
	We considered all those issues in our report. We produced a list of recommendations that my hon. Friend the Minister has looked at, and she will have seen that No. 1 is the need for significant additional funding, but that funding must be targeted at disabled children and their families. I very much hope that more money will come from the comprehensive spending review, but it should be given in an open and transparent way, as an investment in services, with clear obligations on service deliverers to show where the money has gone.
	The hon. Members who put together the report hope that a care offer will be developed to create a universal entitlement to a minimum service. We also recommend that the key worker schemes should be extended beyond the excellent early support programme. Families with children with disability need those key workers, and if their children have complex needs, they need them all the way through to the transition to adult services.
	One very important issue for many of those families is the provision of short-break services. According to the Treasury review, 3,000 children are on waiting lists for family-based short breaks. CSCI's figures for 2005 show that only one in 13 disabled children receives regular support services, including short breaks and direct payments.

Tom Clarke: The hon. Gentleman is making an inspiring and extremely well informed speech. May I reassure him that when our review consideredthese matters, including the recommendation of the Select Committee, we unanimously endorsed that recommendation? I hope that he will find some comfort in that view.

John Bercow: I am extremely grateful to the right hon. Gentleman. That is consistent with the non-partisan spirit that ought, as far as is possible, to inform these debates, and has certainly characterised the discussions that I have had with the right hon. Gentleman over a period of nearly a decade. It was an incisive intervention which happened to help my cause, and I am grateful to him.
	We talk, as I said, about early intervention. In very broad terms admitting of some oversimplification, one can categorise the debate in terms of deciding what is needed and then ensuring that it is available. On the subject of determination, I believe that we suffer continually in this country from a problem of late assessment, late identification and late diagnosis. I recognise, as the Under-Secretary of State for Work and Pensions, the hon. Member for Stirling (Mrs. McGuire) would argue if I did not, that in the case of a child there is a process involved, that development can proceed at different rates, and that it is legitimate to allow for periods in which changes in behaviour or performance can be achieved. However, I believe that sometimes those operating the system play precisely upon the hopes, as well as the more exaggerated fears, of some parents by saying, "Don't worry. There's plenty of time." Of course, those who are articulating that message very often have a reason of financial self-interest for holding back the provision of what is needed. I say to the hon. Lady that there is a problem in that regard.
	There are magnificent people working in the public service for disabled children. I think, for example, of health visitors, early years workers, teaching assistants and qualified teachers. Therefore, it might be politically incorrect to say what I am about to say, but, notwithstanding their experience and their dedication, they are not always remotely well trained or equipped specifically to identify the range of impairments from which children can suffer. We all know of stories from all parts of the House of people who had to wait two, three or four years to get the assessment that is needed. I know of a recent case that was highlighted to meby the National Autistic Society of a child whose diagnosis was incredibly late and who suffered grievously in consequence. We know that one in five schools does not possess a single teacher who has had more than a day's training in the phenomenon of autism. That person is inevitably not well equippedto identify the difficulties, still less to offer a prescription.
	I suggest a practical way forward. Let me ask the Under-Secretary of State for Health, the hon. Member for Bury, South (Mr. Lewis), who will respond on behalf of the Government, why not listen to the view of the Association for All Speech Impaired Children, of which I am fortunate recently to have become a patron? It made a submission to the Treasury review on services for disabled children. It suggested the development through specialist expertise of a particular screening test that would help at an early stage in a range of schools to identify who suffered from which impairment and how that child might best be helped. A speech and language therapist could develop such a test at a relatively modest cost, and the expertise could then be spread across the piece.
	We must also take account of the problems that result from lack of capacity. I appreciate that the Government have invested significant resources—I respect that, applaud it and believe that some benefits can flow from it. However, a difficulty remains. If a child is integrated into mainstream education, with no additional provision or frills because the impairments are judged to be relatively modest, so be it, but we must still ensure that trained staff are readily accessible to deliver assistance of a quality, in a quantity and at a time required. That does not always happen.
	Schools have language units attached to them that often provide for children with somewhat more pronounced difficulties. Again, I declare an interest because my son started school at such a facility last week, and I have high hopes of what might be achieved there. We need more of them and we must ensure that there is a quality team available, preferably in the school. I should like a speech and language therapist to be based in every primary and secondary school in the country. However, when that cannot happen, we need training for people and peripatetic provision of considerable intensity at regular intervals. We must define what we mean by "regular" for individual pupils.
	At the severe end of the spectrum, we must ensure either that we have highly qualified local people who can deliver and develop capacity sufficiently to ensure that every child gets what is necessary or we have to go for something else. We must have regional centres of excellence and the use of expertise, the better to cater for such difficulties.
	The Under-Secretary knows that in "Every Child Matters", the word "specialist" is used no fewer than 32 times. In "Removing Barriers to Achievement", it appears 68 times. He knows that in 2002 the Audit Commission deplored the shortfall in specialist provision and that the Government have said that there must be high quality, intensive, local provision available before a decision is made either to reduce places in a special school or to close whole institutions. I emphasise the importance of that in the context of dealing with low incidence, serious, persistent, complex and multifaceted impairments.
	The Government have done some good work, but there are genuine weaknesses in the system that need to be tackled. In my judgment, too many children have suffered too much for too long. They get too little, too late and the recovery that then has to take place is an enormous challenge for them, their families and the educational system. Let us resolve to go forward, improve policy and ensure that every child gets the best deal that can be offered.

Andrew Selous: We have had a mainly thoughtful debate on the opportunities for the United Kingdom's 700,000 or so disabled children. We have heard about complexity in the benefits system, duplication in parts of social services and inflexibility in parts of the education system. That all results in a less than fully effective use of taxpayers' money, which means that we are not reducing child poverty as fast as we would like, that the quality of life for disabled children, their families and carers is not as high as it could be, and that the opportunities open to those children are not as great as they should be.
	Last week I had the pleasure and privilege of visiting Hillcrest special school for children with severe learning difficulties in Houghton Regis. The school is very well regarded, and I pay tribute to its staff, and especially to its excellent head, Peter Skingley. I spent my time at the school speaking to a large group of parents and staff about their day-to-day experiences of caring for disabled children. A mother of three children with complex needs told me how, 19 years after first coming into contact with services for disabled children, she and others like her are still fighting for the same things. Recently, their experiences have included fighting for two years even to get a diagnosis, fighting to get a child into the right school, battling for 18 months or more with a tribunal and feeling that they were not being listened to, and waiting for three years to get respite care following the closure in 2003 of Appledore, the only local home in the south of the county providing respite care for children with complex needs.
	Both Government and Opposition Members should feel admonished by what those parents had to say. I must say to Ministers that I am a little surprised that the Government amendment is not more realistic about the day-to-day experiences of such parents. Instead, it congratulates and commends the Government on their achievements no less than three times.
	Parents say that no one tells them what is available. The provision of a checklist of social security benefits, care services, school placements, health services, disability aids and adaptations and respite care, perhaps by local primary care services, at the start of a disabled child's life, should be automatic, would cost virtually nothing and would prevent years of missed benefits and services. To his credit, that is a point that the hon. Member for Edinburgh, West (John Barrett) has raised on more than one occasion in the House.
	Last June, a nurse consultant from Bedfordshire Heartlands PCT came to see me to ask my help in dealing with the multiple assessments undergone by disabled adults and children, which cause difficulties for all concerned. As a start, within the Department for Work and Pensions, information on existing databases could be shared, thus saving money that would be spent on creating a new database. I commend my hon. Friend the Member for South-West Surrey (Mr. Hunt) on the comprehensiveness with which he described the multiple assessment process that applies across Government and also encompasses many local authorities.
	The issues that we are dealing with range across several Departments. At the moment there is no Minister from the Department for Education and Skills on the Treasury Bench. I am disappointed about that, as I understand that it is the lead Department, and I want to raise the issue of parents who do not know that their disabled children have been physically restrained at school. I have mentioned the subject in the House before, in the presence of the Minister for Schools. My personal view is that all parents should be told promptly, ideally on the same day, if their child has been physically restrained at school.  [Interruption.] Ministers say "Obviously", but there is only voluntary guidance on the issue. There is a circular known as 10/98 from the Department for Education and Skills which strongly recommends that that should happen, and one or two local authorities—one is St. Helens in Merseyside—make it mandatory throughout maintained schools in their LEA areas.
	Members can imagine how serious the situation is for disabled children who cannot tell their parents what happened to them at school that day. My hon. Friend the Member for Buckingham (John Bercow) spoke movingly and powerfully, as he has on many occasions, about the specific needs of children with speech and language difficulties. I commend him for doing so, as I am sure do all Members. Like, probably, everyone who heard him, I was particularly shocked to learn of the proportion of children in his area who are in the "not in education, employment or training" category because of speech and language difficulties. I think that we are all concerned about speech and language therapy, and that statistic alone was highly valuable.
	I mentioned physical restraint because of two cases made known to me recently. In one case, a mother only realised what was happening because her child came home from school with tears in her jeans. In another case, a severely autistic child was only able to tell his parents what had happened to him at school a year or so after the event. That is now the subject of an investigation, not before time.
	Teachers at special schools have expressed concern to me that there is no longer any initial teacher training for those who want to work with special needs children. I understand that there was such training about20 years ago. There is now a danger that when the current cohort of special school heads and senior staff retire, the teachers who replace them will not have benefited from the initial training. That was mentioned to me specifically by Peter Skingley of Hillcrest special school, and I think it is a valid point. I am glad to see that an Education Minister is now present, and I hope that he will convey that point to his Department.
	The transition from children's to adults' services was raised by my hon. Friend the Member for Tiverton and Honiton (Angela Browning) in an intervention,and also by the hon. Member for South Antrim(Dr. McCrea). Parents to whom I have spoken locally have raised with me the timing of the assessment involved. It often happens extremely late, just before the transfer, which causes all manner of worry and stress to parents and families.
	A transfer might involve an assessment of, for example, a young person wishing to proceed to a college of further education. If it were not carried out in good time, that young person's chance of getting into the college might well be affected. Indeed, on the subject of education, the issue of special needs places in FE colleges has also been raised with me. Again, I would be grateful if the Department for Education and Skills would look into that. There is no reason why those assessments could not be done a good 18 months to two years in advance of the transfer. That would be sensible. There would be no extra cost involved, and it would reduce the stress for all concerned.
	I am sorry that we did not have the chance to hear more Back-Bench speeches tonight. There has been some criticism of the fact that this has been the subject of an Opposition day debate. I do not take that view. These matters are so serious that any opportunity to debate them in this Chamber is valuable.
	We have had some constructive suggestions as to how we can take a number of those issues forward. It is the contention of my hon. Friends, and indeed many other hon. Members, that in some cases it should be possible to organise services for disabled children more effectively than is being done at the moment. I hope that there will be an honest recognition of that from Ministers. Those outside the House who are watching this debate or will read transcripts of it afterwards are looking not for party political point scoring but for a realistic appraisal of where we are now, and positive practical proposals to improve the opportunities for disabled children. We want constructive debate, because for the children, their families and carers, these issues are too serious for anything less. That is the point that my hon. Friend the Member for South-West Surrey, the shadow Minister for the disabled, made tonight.
	I am delighted that we have had an opportunity to debate these matters. We need to continue to do so. I commend the work undertaken by the two Labour Members who have spoken. I am pleased that we heard, by way of an excellent speech, from the hon. Member for Blackpool, North and Fleetwood (Mrs. Humble) and, by way of a series of interventions, from her colleague, whose constituency name—he must forgive me—momentarily escapes me. He was one of the co-organisers of the parliamentary hearings. I pay tribute—

Ivan Lewis: The subject of this debate should unite all parties. We can reflect with some pride on the advances that have been made, but frankly, we still have a long way to go, as the "Every Disabled Child Matters" campaign and the recent parliamentary hearings prove.
	We have had a good debate in which many important issues have been raised. I want to begin my speech by paying particular tribute to the work done in this House by my right hon. Friend the Member for Coatbridge, Chryston and Bellshill (Mr. Clarke) and my hon. Friends the Economic Secretary to the Treasury and the Member for Blackpool, North and Fleetwood (Mrs. Humble) in shining a long overdue light on the needs of disabled children and their families. I also pay tribute to the children's charities and carers' organisations and the many individual parents and professionals who have fought for the rights of disabled children over many decades. I recognise, too, that there are Members of all parties who are genuine in their commitment to improving the life chances of disabled children and their families.
	Children with disabilities are children first, with the same right to fulfil their potential, and to have a life free of poverty and full of hopes and dreams, as we seek for every child. Parents have the right to expect support that is personalised to their needs and the needs of their child, and a system that exists to provide solutions, not erect barriers. The mother of a disabled child in my constituency summed things up recently when she told me of her experiences: "Why do I have to shout before anyone will listen?" and "I am the expert when it comes to my son" are just two of the comments that struck an all-too-common chord.
	The needs of disabled children and their families represent the beginning of my journey to this House. At the age of 14, I began doing voluntary work for Outreach, a voluntary organisation that still serves my constituents by supporting children with learning disabilities on school holiday play schemes. I then started to support adults with learning disabilities on a leisure integration programme. That became my passion and my career choice. At the age of 19, I set up and ran a small voluntary organisation, Contact, a community care group offering children and adults leisure opportunities as well as providing respite to families. Contact still offers support to adults and their families in my constituency.
	Through that work, I learned much about myself, but more importantly I learned so much about the realities faced by disabled people of all ages and their families and carers. That taught me the values that are the foundations of my political beliefs, and it makes me proud to have the opportunity in Government to influence, and sometimes shape, change in that regard. I and my ministerial colleagues are strongly committed to policies such as "in Control", direct payments and individual budgets, which will transfer power and control in the delivery and shaping of services from organisations to those who use services and their families.
	So what are the values to which I refer? Every disabled child is an individual with distinct needs, emotions and potential. Every disabled child has a fundamental right to be included as part of their community and our society. I get angry when I hear some politicians and commentators deride inclusion as having failed and as being simply about political correctness, and when they talk only of those parents seeking special or segregated education, and when they talk about disabled children in a patronising, demeaning way.
	Of course our system is not yet as good as it needs to be in terms of specialist expertise, sensitivity and resources; the hon. Member for Buckingham (John Bercow) made that point. Attitudes, including among some educationalists, are not always as they should be.
	I accept that some parents still feel that special schools are the best available option. In my constituency, I am proud of Elms Bank which was one of the first special secondary schools to achieve specialist status and recently made it into the top 5 per cent. of schools for value added performance, including mainstream schools.
	I could also however introduce Members to many parents who have fought against the professionals and the system to demand a mainstream education for their children, and who could describe the thrill of their child's first day alongside their non-disabled brother or sister at the local school, or who have cried themselves to sleep because the local education system has come up with all sorts of reasons why their child has to be excluded from the mainstream system. Those parents deserve to be heard in this debate, and more generally.
	The hon. Member for Buckingham, who now has extremely important personal experience, made a fantastic speech which I could not disagree with a word of. He talked about the importance of trained support staff. Our debate should not be about being for or against inclusion; we should recognise that to make a reality of inclusion, which should be the norm for the vast majority of disabled children, we have to get to a situation in which specialist support staff are available to provide the necessary support.
	In the context of change, I remember those who vigorously opposed the closure of the long-stay mental handicap hospitals in the 1980s and 1990s. They said that "mentally handicapped" people could not possibly live in the community; that they needed looking after by nurses; that they somehow posed a risk to children. I wish that those people could see today adults with learning disabilities being supported in living in their own homes by organisations such as Outreach and Build, in my constituency. After 30 or 40 years of being locked away in institutions, they live ordinary lives as neighbours, friends and family members in our community. In my current role, and in the aftermath of Cornwall and Orchard Hill, I am determined to ensure that the remaining four hospitals are closed and the residents provided with the support that they deserve in the community.
	Change should of course be done properly, for the right reasons and with respect for the needs and preferences of children and their parents, but inclusion is right. Members should reflect on this: how many citizens opt for exclusion from society when given an authentic choice? We need to think about that when we make such policy decisions. Our long-term goal should be to maximize inclusion in education, health, leisure and work and all areas of public policy.
	I also want to share with Members my view of Scope's current campaign as it relates to the recent decision to restrict the growth of a disabled child in the United States of America. I am always reluctant to appear in any way critical of parents and the difficult decisions that they make about their children. That is particularly the case when, owing to a serious disability, the parent may feel genuinely unable to establish the view of the child or young person. However, I believe that every child has the right, irrespective of any disability, to grow into an adult physically, and with all the rights and opportunities available to every other citizen. Scope, in my view, is right to make a stand in this country on that issue.
	Over the years, much of my personal inspiration has come from examples of battling parents, grandparents and carers: people such as Lynne Elwell, who, following her many negative experiences of the system as the mother of the late Nicola, has created a national network called Partners in Policymaking. I urge Members in all parts of the House to find out more about that organisation. Parents and people with learning disabilities participate in training courses, leading to the status of a Partners graduate. Partners in Policymaking empowers parents and disabled people to build their confidence, knowledge and support systems, so that they can fight for their rights as partners, not as adversaries of professionals and the system. I say to my hon. Friend the Member for Blackpool, North and Fleetwood that, in many ways, the best advocates are parents who have themselves been through the system and can represent the interests of other parents. I believe very strongly in building such networks around the country.
	When I speak to Raymond, the late Nicola's father, I feel not only the acute pain of his loss, but his enduring anger at the failure of the system on so many occasions during her life. We should also consider people such as Geraldine Green, who is not only a full-time carer for her grandchildren but runs an enterprising local voluntary organisation called Hurdles, which offers a range of support for disabled children and their families in my constituency and that of my hon. Friend the Member for Bury, North (Mr. Chaytor). These individuals and, as the hon. Member for South-West Surrey (Mr. Hunt) said in his opening remarks, many others are the heroes whose vision and commitment have been born out of frustration—sometimes anger—at the failings of the system.
	I now turn to some of the contributions made by Members. The hon. Member for South-West Bedfordshire (Andrew Selous) talked about the importance of information sharing between agencies to ensure that people get a truly joined-up service. I share that view, but I ask him to reconsider his party's opposition to data sharing on the sometimes spurious ground of civil liberties. On physical restraint, I should also point out that Opposition Members cannot say that they are against targets imposed by central Government, and then ask us to direct every head teacher in every school in the country to do what, frankly, I believe should be regarded in most schools as best practice. The hon. Gentleman is wrong about initial teacher training, which has a significant focus on the requirement to be sensitive to special educational needs, but we can share more information with him on that issue at another time. As a distinguished member of the Work and Pensions Committee, the hon. Gentleman signed up to a report that said that the Government were on target to halve child poverty by 2010, but tonight he has signed up to a motion claiming that that will not be achieved.
	The hon. Member for Inverness, Nairn, Badenoch and Strathspey (Danny Alexander)—that is a difficult one at this time of night—made an excellent speech. It was fair, balanced, credible and sensible. He made the important point that the interventions that we make in childhood and the early years do not affect the child only during that period of their life, but their whole life opportunities. He made several other important points.
	My hon. Friend the Member for Blackpool, North and Fleetwood was once the chair of a social services committee, as I was, and she made several very important points. Of course we have to grapple with the consequences of demographic change, which means that people thankfully live longer and have fuller lives, but their disabilities can also be more complex and more challenging. She was right to refer to the centrality of the transition from being a child to being a young adult, and the need—as we are now doing across Government—to have that as a standing item on the inter-ministerial group that looks at all matters to do with disabled people. She was also right to draw attention to the fact that key workers should be at the heart of a future system, in terms of guiding parents through all the complex issues.

That the draft Uncertificated Securities (Amendment) Regulations 2006, which were laid before this House on18th December, be approved.

That the Financial Services and Markets Act 2000(Regulated Activities) (Amendment No. 3) Order 2006 (S.I., 2006,No. 3384), dated 18th December 2006, a copy of which was laid before this House on 18th December, be approved.
	That the draft Financial Services and Markets Act 2000 (Exemption) (Amendment) Order 2006, which was laid before this House on 18th December, be approved.
	That the draft Financial Services and Markets Act 2000 (Markets in Financial Instruments) Regulations 2006, which were laid before this House on 18th December, be approved.

Richard Caborn: First, I congratulate my hon. Friend the Member for Paisley and Renfrewshire, North (Jim Sheridan) on his success in securing a debate on an interesting subject. Both the Secretary of State and I are aware, from correspondence with the Football Association and Football DataCo, that it is an issue of great concern to football clubs, both in England and north of the border, so I am grateful to my hon. Friend for giving the House an opportunity to discuss it.
	As my hon. Friend explained, football's main concerns arise from a ruling by the European Court of Justice in 2005 that sports bodies cannot charge betting operators monopoly prices for data such as match fixture lists. As a result, Football DataCo, which passes its proceeds on to the Scottish and English leagues, can no longer sell data to pools companies and bookmakers. I accept that the directive has led to a loss of revenue for football, but that should not be exaggerated. To make progress and to help the Scottish clubs that have been particularly affected, we must secure more voluntary agreements between football and the betting industry, and urge football's governing bodies to look at the way in which any specific shortfalls can be met by other revenue streams. I shall address the specific points made by my hon. Friend to demonstrate why we must do so.
	First, I wish to make it clear that a good case has not yet been made for the UK to reopen the issue of the database directive, and that the Government have no plans to do so. The directive was introduced with the reasonable intention of protecting the investment of database providers who have not just created data, but made a new and valuable product with that information. In 2005, the European Court of Justice clarified the distinction between two types of database—the protected and the non-protected—and it became clear that the database held by Football DataCo was not protected.
	It is true that the decision of the European Court of Justice has meant that some sporting bodies are looking for alternative sources of funding as they are unable to license the data from their fixture lists, but the decision has also clarified what the law means. To re-open it now would cause a great deal of uncertainty for the database industries, at exactly the time when, finally, they have a clear understanding of the level of protection accorded to their databases. In any case, as my hon. Friend knows, any change would have to be based on a consensus between the other EU member states, which would be difficult to achieve, as I think he would accept.
	I should be clear that the Government have no intention of creating a new intellectual property right to cover sport databases in order to give them a monopoly over the use of simple data such as fixture lists. Discussions with the Patent Office have confirmed that there are no grounds to amend our database regulations or to make special intellectual property rights in this case. I firmly believe that agreements between the sport and the betting industry are the right way forward.
	That is why in February last year I brought together Ladbrokes and the premier league. I am pleased to say that the result of this meeting was that Ladbrokes, William Hill, Coral and a number of other bookmakers agreed to a five-year funding deal for football, through continuing voluntary payments for the use of data via Football DataCo. This year, their contributions amounted to just over £3 million, and I am grateful to Football DataCo for the excellent job it is doing in distributing this income to football clubs north and south of the border.
	In particular, I am grateful for the contributions made to smaller clubs. As my hon. Friend knows, last year, over £500,000 of bookmakers' contributions went to Scottish football clubs, via Football DataCo. I realise that the company wants to increase that amount and I have some sympathy with that aim. That is why I give my full support and encouragement to continuing discussions with bookmakers who are not currently making voluntary contributions, with the aim of increasing the total income from betting to football.
	The shortfall, once voluntary agreements have been factored in, is a little over £2 million. Although this may be small change in the overall scheme of things—the premier league's recent agreement on media and TV rights packages for the three years from the start of the 2007-08 season is £2.7 billion—it highlights what I believe is a golden opportunity for all involved in the game to think again about how grassroots football is supported, in the light of the wider debate triggered by the publication of the independent European sport review, to which my hon. Friend rightly referred.
	In the short term, I am confident that, through further voluntary agreements and perhaps income from other sources, the effects of the loss of revenue can be minimised. I would encourage those involved in the game to explore longer-term and sustainable means of ensuring that the grassroots and smaller clubs on whom the future of the game depends are financially stable and are rewarded for the vital contribution that they make. The question for football is how it ensures that its unprecedented commercial success in recent years can be used to ensure its long-term success and stability through supporting the grassroots on which those depend.
	It is understandable why a comparison is sometimes made between the situation in horse racing—this was central to my hon. Friend's argument—where we have recently announced the retention of the horse race betting levy on bookmakers, and other sports, where there is no such levy. Let me explain why there is no question of the Government establishing for football or any other sport a levy analogous to the horse race levy. First, horse racing still makes up about 50 to60 per cent. of betting business in the UK. Although betting on football is increasing, it is not yet even close to that level. The horse race betting levy acknowledges the special relationship between horse racing and betting, and was established back in the 1960s on that basis.
	Secondly, any new levy or sports betting right is likely to constitute illegal state aid from the point of view of the European Commission. Policy would have to be implemented at EU level to facilitate sports levies across all member states, and it would then be up to national Governments to implement them. The Government ultimately aim to replace the horse race betting levy with a more modern, sustainable and commercial arrangement between the bookmakers and horse racing. We do not perceive the levy as a model for the future funding of any other sport.
	To sum up, I believe that, although that the effect of the European Court of Justice ruling on databases has had some effect on the financial contribution of gambling companies to football, it needs to be put into perspective in terms of the amounts and the directive's wider benefits. There is no convincing case to show that it has had a significantly negative effect on the overall financial position of the sport. I am confident that, given the determination and commitment of the football authorities, any losses can be recouped through further voluntary agreements between the industries. The Government's position is clear—it is up to the bookmakers and the football authorities, as two independent commercial interests, to come to further financial agreements. I will do all in my power to facilitate that and I encourage those bodies to come together and find a solution.
	I believe that the actions that we have taken so far and future agreements between the two main parties will resolve the matter. If we can do that, football and, indeed, other sports, will be enhanced.
	 Question put and agreed to.
	 Adjourned accordingly at nineteen minutes toEleven o'clock.